Multi-function surgical instrument tool actuator assembly

ABSTRACT

A tool actuating assembly for a multi-function surgical instrument is disclosed. The tool actuating assembly of the present invention can be utilized in a variety of differently configured multi-function surgical instruments and can be embodied in various physical configurations. The tool actuating assembly of the present invention provides for more efficient use of the tools of the instrument by the surgeon who is utilizing the instrument.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a divisional of application Ser. No. 10/437,995,filed May 15, 2003 now U.S. Pat. No. 7,217,264, which is a continuationof application Ser. No. 09/704,659, filed Nov. 3, 2000, now U.S. Pat.No. 6,589,231, which is a divisional of application Ser. No. 09/192,568,filed Nov. 17, 1998, now U.S. Pat. No. 6,162,209.

BACKGROUND OF THE INVENTION

The present invention relates to a multi-function surgical instrument.More specifically, the invention provides a surgical tool actuatorassembly for a multi-function surgical instrument.

Currently, multi-function surgical instruments are being utilized bysurgeons when performing surgical procedures. These multi-functionsurgical instruments contain multiple surgical tools within the singleinstrument which allows the surgeon to perform a procedure withoutrequiring the surgeon to remove and insert multiple instruments withinthe patient. The incorporation of multiple tools within a singleinstrument provides efficiencies for the surgeon when performing theprocedure.

There are drawbacks, however, with currently known multi-functionsurgical instruments. Because multiple tools are incorporated into thesingle instrument, the mechanism of the surgical instrument that isutilized to operate the tools within the instrument can be complexand/or inefficient to use. Thus, the efficiencies that are obtained fora physician by incorporating multiple tools within a single instrumentcan be negated by the complexities and/or inefficiencies involved withoperating the tools of the instrument.

Therefore, it would be desirable to provide a multi-function surgicalinstrument tool actuating assembly that would provide for more efficientuse of the tools of the instrument by the surgeon who is utilizing theinstrument.

SUMMARY OF THE INVENTION

The present invention is directed to overcoming many of the deficienciesthat exist with the tool operating mechanisms of multi-function surgicalinstruments. The present invention provides an improved tool actuatingassembly for a multi-function surgical instrument. The tool actuatingassembly of the present invention can be utilized in a variety ofdifferently configured multi-function surgical instruments and can beembodied in various physical configurations.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a side view of a multi-function surgical instrument thatincorporates a first embodiment for a tool actuator assembly inaccordance with the present invention.

FIG. 2 is a cross-sectional view of the multi-function surgicalinstrument and tool actuator assembly of FIG. 1.

FIG. 3 is a side view of the surgical instrument of FIG. 1 with theneedle exposed from the sheath.

FIG. 4 is a side view of the surgical instrument of FIG. 1 with thesnare loop exposed from the sheath.

FIG. 5 is a side view of a multi-function surgical instrument thatincorporates a second embodiment for the tool actuator assembly of thepresent invention.

FIG. 6 is a cross-sectional view of the multi-function surgicalinstrument and tool actuator assembly of FIG. 5.

FIG. 7 is a side view of the surgical instrument of FIG. 5 with theneedle exposed from the sheath.

FIG. 8 is a side view of the surgical instrument of FIG. 5 with thesnare loop exposed from the sheath.

FIG. 9 is a top view of a multi-function surgical instrument thatincorporates a third embodiment for the tool actuator assembly of thepresent invention.

FIG. 10 is a side view of the multi-function surgical instrument of FIG.9 with both the snare and the injection needle disposed within thesheath.

FIG. 11 is a top view of the multi-function surgical instrument of FIG.9 with the injection needle exposed from the sheath.

FIG. 12 is a top view of the multi-function surgical instrument of FIG.9 with the snare exposed from the sheath.

FIG. 13 is a top view of a multi-function surgical instrument thatincorporates a fourth embodiment for the tool actuator assembly of thepresent invention.

FIG. 14 is a side view of the multi-function surgical instrument of FIG.13 with both the snare and the injection needle disposed within thesheath.

FIG. 15 is a top view of the multi-function surgical instrument of FIG.13 with the injection needle exposed from the sheath.

FIG. 16 is a top view of the multi-function surgical instrument of FIG.13 with the snare exposed from the sheath.

FIG. 17 is a side view of a multi-function surgical instrument thatincorporates a fifth embodiment for the tool actuator assembly of thepresent invention.

FIG. 18 is a side view of a multi-function surgical instrument thatincorporates a sixth embodiment for the tool actuator assembly of thepresent invention.

FIG. 19 illustrates the tool actuating member of the embodiment of FIG.18.

FIG. 20 illustrates the proximal end of the surgical instrument of FIG.18.

FIG. 21 illustrates the tool actuator member of the embodiment of FIG.18 in a first position where a distal end of an injection needle is notin an operative position.

FIG. 22 illustrates the tool actuator member of the embodiment of FIG.18 in a second position where the distal end of the injection needle hasbeen extended from the surgical instrument.

FIG. 23 illustrates the tool actuator member of the embodiment of FIG.18 in its second position.

FIG. 24 illustrates an injector adaptor port that can be utilized withthe multi-function surgical instrument of FIG. 18.

FIG. 25 is a perspective view of a multi-function surgical instrumentthat incorporates a seventh embodiment for the tool actuator assembly ofthe present invention.

FIG. 26 is a side view of the multi-function surgical instrument of FIG.25.

FIG. 27 is a side view of the top switching member of the embodiment ofFIG. 25.

FIG. 28 is a bottom view of the top switching member of FIG. 27.

FIG. 29 is a perspective view of the bottom switching member of theembodiment of FIG. 25.

FIG. 30 is a top view of the bottom switching member of FIG. 29.

FIG. 31 is a side view of the top switching member and bottom switchingmember of FIGS. 27-30 in an operable configuration.

FIG. 32 is a top view of the sliding finger ring assembly of theembodiment of FIG. 25.

FIG. 33 is a rear view of the sliding finger ring assembly of FIG. 32.

FIG. 34 is a bottom view of the sliding finger ring assembly of FIG. 32.

FIG. 35 is a side view of the first instrument hub of the embodiment ofFIG. 25.

FIG. 36 is a top view of the first instrument hub of FIG. 35.

FIG. 37 is a bottom view of the first instrument hub of FIG. 35.

FIG. 38 is a rear view of the first instrument hub of FIG. 35.

FIG. 39 is a perspective view of the tool selection and locking switchin an operable configuration with the first and second instrument hubsof the embodiment of FIG. 25.

FIG. 40 is a side view of the tool selection and locking switch of FIG.39.

FIG. 41 is a cross-sectional view of the surgical instrument of FIG. 25taken along line 41-41 of FIG. 26.

FIG. 42 is a perspective view of a multi-function surgical instrumentthat incorporates an eighth embodiment for the tool actuator assembly ofthe present invention.

FIG. 43 is a perspective view of an operable configuration of the firstand second actuator buttons, the sliding finger ring assembly; and thefirst and second instrument hubs of the embodiment of FIG. 42.

FIG. 44 is a perspective view of an operable configuration of the firstand second actuator buttons and the first and second hub engagementmembers of the embodiment of FIG. 42.

FIG. 45 is a rear view of the multi-function surgical instrument of FIG.42.

FIG. 46 is a cross-sectional view of the multi-function surgicalinstrument of FIG. 42 taken along line 46-46 of FIG. 45.

FIG. 47 is a cross-sectional view of the multi-function surgicalinstrument of FIG. 42 taken along line 47-47 of FIG. 45.

FIG. 48 is a cross-sectional view of the multi-function surgicalinstrument of FIG. 42 taken along line 48-48 of FIG. 47.

FIG. 49 is a cross-sectional view of the multi-function surgicalinstrument of FIG. 42 taken along line 49-49 of FIG. 45.

FIG. 50 is a cross-sectional view of the multi-function surgicalinstrument of FIG. 42 taken along line 50-50 of FIG. 49.

FIG. 51 is a perspective view of a multi-function surgical instrumentthat incorporates a ninth embodiment for the tool actuator assembly ofthe present invention.

FIG. 52 is a top view of the multi-function surgical instrument of FIG.51.

FIG. 53 is a perspective view of the guide bar of the embodiment of FIG.51.

FIG. 54 is a top view of the guide bar of FIG. 53.

FIG. 55 is a side view of the guide bar of FIG. 53.

FIG. 56 is a front view of the guide bar of FIG. 53.

FIG. 57 is a bottom view of the guide bar of FIG. 53.

FIG. 58 is a cross-sectional view of the guide bar of FIG. 53 as takenalong line 58-58 of FIG. 57.

FIG. 59 is a perspective view of the first and second instrument hubs ofthe embodiment of FIG. 51.

FIG. 60 is a front view of the first and second instrument hubs of FIG.59.

FIG. 61 is a side view of the second instrument hub of FIG. 59.

FIG. 62 is a bottom view of the first and second instrument hubs of FIG.59.

FIG. 63 is a rear view of the first and second instrument hubs of FIG.59.

FIG. 64 is a perspective view of the sliding finger ring assembly of theembodiment of FIG. 51.

FIG. 65 is a front view of the sliding finger ring assembly of FIG. 59.

FIG. 66 is a top view of the sliding finger ring assembly of FIG. 59.

FIG. 67 is a perspective view of the hub actuator of FIG. 51.

FIG. 68 is a perspective view of the finger ring assembly and hubactuator of the embodiment of FIG. 51.

FIG. 69 is a perspective view of the hub actuator, guide bar, and firstand second instrument hubs of the embodiment of FIG. 51.

FIG. 70 is a cross-sectional view of the surgical instrument of FIG. 51taken along line 70-70 of FIG. 52.

FIG. 71 is a cross-sectional view of the surgical instrument of FIG. 51taken along line 71-71 of FIG. 52.

FIG. 72 is a perspective view of a sheath stress relief member that canbe utilized with the multi-function surgical instrument of FIG. 51.

FIG. 73 is a side view of the sheath stress relief member of FIG. 72.

FIG. 74 is a front view of the sheath stress relief member of FIG. 72.

FIG. 75 is a cross-sectional view of the sheath stress relief member ofFIG. 72 taken along line 75-75 of FIG. 74.

FIG. 76 is a side view of a tenth embodiment for the tool actuatorassembly of the present invention.

FIG. 77 is a perspective view of the tool actuator assembly of FIG. 76.

FIG. 78 illustrates the internal working components of the tool actuatorassembly of FIG. 76.

FIG. 79 illustrates the needle, first locking member, and hub of thetool actuator assembly of FIG. 78.

DETAILED DESCRIPTION

FIG. 1 illustrates a first embodiment for a surgical tool actuatorassembly in accordance with the principles of the present invention. Itshould be noted that the present invention can be practiced in any of avariety of different configurations for a surgical instrument wheremultiple surgical tools are contained within the surgical instrument andthe present invention is not limited to being practiced in anyparticular embodiment for the multi-function surgical instrument itself.A first embodiment for a multi-function surgical instrument and a firstembodiment for the tool actuator assembly of the present invention areillustrated in FIG. 1.

As is illustrated in FIG. 1, surgical instrument 100 is a multi-functionsurgical instrument that contains a first surgical tool 150, which is asnare, and a second surgical tool 160, which is disclosed in theembodiment of FIG. 1 as being an injection needle. As can be seen inFIG. 1, surgical instrument 100 includes a body 110, a shaft, or sheath,120, a finger ring 130, and an actuator button 170. Snare 150 and needle160 are disposed within sheath 120 when both tools are in anon-operative position. Snare 150 and needle 160 can be any of a varietyof known devices and the present invention is not limited to anyparticular embodiment for the snare and the needle. Additionally, asmentioned previously, the present invention is not limited to anembodiment where the first surgical tool 150 is a snare and the secondsurgical tool 160 is a needle. The present invention can be practicedwith any of a variety of tools, e.g., a brush, grasper, balloon, cauterytool, basket, etc.

Body 110 is a generally tubular member that includes a guiding slot 114in a distal end 112A of the body 110 and includes a thumb ring 140 at aproximal end 112B of the body. Also included in body 110 is injectionport 132 which is utilized to provide fluid to surgical instrument 100for injection into the body of a patient through needle 160. Guidingslot 114 is comprised of openings on opposed sides of body 110 such thatan opening extending through body 110 is formed by guiding slot 114.Actuator button 170 is disposed within body 110 for sliding motionwithin body 110. As such, actuator button 170 includes a head portion172, an elongated stem portion 174, and slot guide 176. Slot guide 176is comprised of two guide tabs that are disposed on opposed sides ofelongated stem portion 174 and which are received within guiding slot114 of body 110. As such, actuator button 170 is disposed within body110 for sliding motion with respect to body 110 by positioning slotguide 176 within guiding slot 114. Additionally, actuator button 170 isrigidly attached to sheath 120, which is disposed within body 110 forsliding motion with respect to body 110. Actuator button 170 is utilizedto retract a portion of sheath 120 within body 110. As will be furtherexplained, the retraction of sheath 120 within body 110 exposes thedistal end 162 of needle 160 beyond the distal end 122 of sheath 120.

Sheath, or shaft, 120, in the embodiment of FIG. 14, and for the otherembodiments disclosed later in this specification or contemplated bythose skilled in the art, can be comprised of either a rigid or aflexible structure. The present invention is not limited to anyparticular physical configuration for sheath, or shaft, 120 and itsstructure is determined by the particular type of surgical instrumentwith which the present invention is utilized.

Finger ring 130 is disposed on body 110 for sliding motion on body 110.As will be further explained below, finger ring 130 is attached to snare150 and controls the movement of snare 150 to both retract snare 150within sheath 120 and to extend snare 150 beyond the distal end 122 ofsheath 120.

FIG. 2 is a cross sectional view of the surgical instrument 100 of FIG.1 that illustrates the internal connections of the snare 150, needle160, and sheath 120 within the surgical instrument 100. As can be seenin FIG. 2, needle 160 is a fixed length needle and is rigidly attachedat its proximal end 164 to injection port 132. Snare 150 is rigidlyattached to snare attachment member 134 of finger ring 130. Snareattachment member 134 includes an aperture 135 that extends therethroughsuch that needle 160 is able to extend through snare attachment member134.

Also illustrated in FIG. 2 is the attachment of sheath 120 to actuatorbutton 170. Proximal end 124 of sheath 120 is rigidly attached toactuator button 170. Thus, since sheath 120 is disposed within body 110but is not directly attached to body 110, sheath 120 is able to beretracted into, and extended from, body 110 by the user sliding actuatorbutton 170 within guiding slot 114 of body 110. The methods ofattachment of needle 160 to body 110 (through attachment to injectionport 132), snare 150 to attachment member 134, and actuator button 170to sheath 120 may be by any of a variety of methods and the presentinvention is not limited to any particular attachment method. Forexample, each member may be glued to its respective attachment member orit may be attached by utilizing attachment hardware, such as screws orrivets.

The operation of each tool within surgical instrument 100 will now bedescribed. FIG. 1 illustrates the surgical instrument 100 in aconfiguration where both the snare 150 and the needle 160 are disposedcompletely within sheath 120. As can be seen, in this configurationwhere both the snare 150 and needle 160 are disposed within sheath 120,finger ring 130 is disposed at the proximal end 112B of body 110 andactuator button 170 is disposed at the distal end 114A of guiding slot114.

FIG. 3 illustrates a configuration for surgical instrument 100 whereneedle 160 is now exposed from the distal end 122 of sheath 120. As canbe seen, actuator button 170 has now been moved proximally with respectto body 110 within guiding slot 114. Since sheath 120 is rigidlyattached to actuator button 170, as actuator button 170 is movedproximally along body 110, sheath 120 is retracted within body 110. Ineffect, this decreases the effective length of the sheath 120 thatextends from the distal end 112A of body 110. Since needle 160 has afixed length and its length is selected such that the distal end 162 ofneedle 160 is disposed within sheath 120 when sheath 120 is extendedfrom body 110, any retraction of sheath 120 within body 110 throughoperation of actuator button 170 will expose the distal end 162 ofneedle 160 from the distal end 122 of sheath 120. Thus, in order toexpose needle 160 from sheath 120, needle 160 is not moved relative tobody 110, however, sheath 120 is moved relative to body 110, thusexposing the distal end 162 of needle 160 from the distal end 122 ofsheath 120. In this manner, a surgeon is able to control the extensionand retraction of needle 160 from the surgical instrument by easilyoperating an actuator button that controls the movement of the sheath120 of the surgical instrument.

FIG. 4 illustrates the operation of snare 150. As can be seen in FIG. 4,sliding finger ring 130 has now been moved distally along body 110 suchthat finger ring 130 is now in a second position. Since snare 150 isrigidly attached to finger ring 130, any movement of finger ring 130along body 110 will also move the snare the same distance that thefinger ring is moved. Thus, as finger ring 130 is moved to its secondposition distally along body 110, the distal end 152 of snare 150, whichis the working part of snare 150, is disposed externally from distal end122 of sheath 120. As was explained earlier, because snare attachmentmember 134, which provides for attachment of snare 150 to finger ring130, includes aperture 135 therethrough, finger ring 130 is able to bemoved on body 110 without effecting movement of needle 160. Finger ring130 and attachment member 134 merely pass over needle 160 as needle 160is positioned within aperture 135 in the snare attachment member 134.Thus, the movement and operation of snare 150 through operation offinger ring 130 is independent of the operation of needle 160, which isactuated through actuator button 170.

Thus, the present invention as embodied in FIGS. 1-4 provides forindependent operation of a first surgical tool and a second surgicaltool and easily operable mechanisms for independently actuating eachtool.

Additional features that could be included with the embodiment of FIGS.1-4 for the operating mechanism for actuating needle 160 are a biasingmeans to bias actuator button 170 in its first position, i.e., where thesheath 120 is fully extended from body 110, and a locking device to lockactuator button 170 in its second position where the actuator button hasretracted sheath 120 within body 110 to expose needle 160 from sheath120. These additional features are not required when practicing thepresent invention but may provide for further assisting an operator ofthe tool with its operation.

These features would not be limited to any particular embodiment and anyof a variety of mechanisms could be utilized to implement thesefeatures. For example, a biasing spring could be provided within body110 that could cooperate with actuator button 170 in order to biasactuator button 170 in its first position. If an operator desired tomove actuator button 170 to its second position, the operator wouldmerely apply sufficient pressure to actuator button 170 such that thepressure overcame the biasing force that biased the actuator button 170into its first position. For the locking feature, should it be desired,a locking tab could be provide on actuator button 170 that couldcooperate with a locking slot that could be provided on body 110. As theactuator button was moved proximally within guiding slot 114, thelocking tab could ride up and over a cam surface associated with thelocking slot and once the locking tab traveled over the cam surface thelocking tab could be engaged within the slot that is included on body110. When the operator desired to move actuator button 170 distallyalong body 110 to return actuator button 170 to its first position, theoperator could manually lift the actuator button up and out of the sloton the body which would disengage the locking tab from the locking slotand then the actuator button could be moved back to its first position.Again, the present invention is not required to be practiced with thesefeatures and if these features are incorporated, the present inventionis not limited to any particular mechanism for implementing thesefeatures.

FIGS. 5-8 illustrate a second embodiment for a surgical tool actuatorassembly in accordance with the present invention. As will furtherexplained, the present invention as embodied in FIGS. 5-8 operates in asimilar manner to the embodiment of FIGS. 1-4, however, the operatingmechanism for retracting sheath 220 within body 210 of multi-functionsurgical instrument 200 is comprised of a different structure.

Similar to the surgical instrument that was described in FIGS. 1-4,surgical instrument 200 of FIG. 5 also includes a body portion 210, aretractable sheath 220 that is partially disposed within distal end 212Aof body portion 210, and a sliding finger ring 230 that is disposed onbody 210 for sliding motion on the body. Surgical instrument 200includes a first surgical tool 250 which is also disclosed as a snare asin the embodiment of FIGS. 1-4, and a second surgical tool 260 which isdisclosed as a needle, also similar to the tool of FIGS. 1-4. Again, thepresent invention may be practiced by utilizing any of a variety ofdifferent tools with surgical instrument 200.

Surgical tool 200 also includes retracting member 270. As will befurther described, retracting member 270 is rigidly attached, internalto body 210, to a proximal end 224 of sheath 220. Retracting member 270includes an engagement head portion 272 that is disposed at a proximalend 212B of surgical instrument 200 and a sheath attachment portion 274that is disposed within body 210 at the distal end 212A of surgicalinstrument 200. Sheath attachment portion 274 includes slot guides 276which are disposed on opposed sides of sheath attachment portion 274. Asin the embodiment of FIGS. 1-4, slot guides 276 are received withinguiding slot 214 that is included in body 210 at distal end 212A ofsurgical instrument 200.

FIG. 6 is a cross-sectional view of the surgical instrument 200 of FIG.5 which illustrates the attachments of snare 250, needle 260, and sheath220 to the surgical instrument 200. As in the embodiment of FIGS. 1-4,needle 260 is comprised of a fixed length member and is rigidly attachedto injection port 232 that is disposed in the proximal end 212B ofsurgical instrument 200. Injection port 232 is utilized to provide afluid that is to be injected into the body of a patient to injectionneedle 260. Also as was described previously for the embodiment of FIGS.1-4, snare 250 is rigidly attached to snare attachment member 234 whichis included in sliding finger ring 230. Snare attachment member 234includes a first aperture 235 which extends completely therethrough suchthat needle 260 can extend through snare attachment member 234 for rigidattachment to injection port 232. Sheath 220 is rigidly attached at itsproximal end 224 to sheath attachment portion 274 of retracting member270. Sheath attachment portion 274 of retracting member 270 is connectedto engagement head portion 272 of retracting member 270 by retractionconnecting member 278. Retraction connecting member 278 is an elongatedmember that rigidly connects sheath attachment portion 274 to engagementhead portion 272. Retraction connecting member 278 is disposed withinhollow body 210 of surgical instrument 200. Snare attachment member 234includes a second aperture 236 through which extends retractionconnecting member 278.

As can be seen in FIG. 6, engagement head portion 272 of retractingmember 270 is disposed on body 210 of surgical instrument 200 to therear of the two finger rings 238 that are included on sliding fingerring assembly 230. Biasing member 280 is disposed within body 210 ofsurgical instrument 200 and is utilized to bias retracting member 270 toa first position which, as will be explained, fully extends sheath 220from body 210 of surgical instrument 200.

FIGS. 5-8 illustrate a second embodiment for a surgical tool actuatorassembly in accordance with the present invention. As will further beexplained, the present invention as embodied in FIGS. 5-8 operates in asimilar manner to the embodiment of FIGS. 1-4, however, the operatingmechanism for retracting sheath 220 within body 210 of multi-functionsurgical instrument 200 is comprised of a different structure.

FIG. 7 illustrates a configuration for the surgical instrument 200 wherethe needle 260 has been exposed from sheath 220. As can be seen, thedistal end 262 of needle 260 extends beyond the distal end 222 of sheath220. In order to extend distal end 262 of needle 260 from sheath 220, anoperator moves sliding finger ring assembly 230 proximally along body210 of the surgical instrument 200. Proximal motion of sliding fingerring assembly 230 will result in engagement of the finger ring assembly230 with engagement head portion 272 of retraction member 270. As fingerring assembly 230 continues its movement proximally along body 210,finger ring assembly 230 will also move retraction member 270 proximallyalong body 210. Pressure applied by a user to move sliding finger ringassembly 230 proximally along body 210 will force retraction member 270proximally along body 210 against the force applied by biasing member280, which biases retraction member 270 in its first position. By movingretraction member 270 proximally along body 210, sheath attachmentportion 274, which is connected to engagement head 272 of retractionmember 270 through retraction connecting member 278, is also movedproximally within guide slot 214 of body 210. Since sheath 220 isrigidly attached to sheath attachment portion 274; proximal motion ofsheath attachment portion 274 will retract sheath 220 a distance withinbody 210. Retraction of sheath 220 within body 210 will expose distalend 262 of needle 260 from the distal end 222 of sheath 220. Thus,through proximal motion of sliding finger ring assembly 230, retractionmember 270 is moved proximally with respect to body 210 which in turnretracts sheath 220 into body 210. The retraction of sheath 220 withinbody 210 exposes the distal end 262 of needle 260 from the distal end222 of sheath 220. Once the operator removes the force from slidingfinger ring assembly 230 that moved the sliding finger ring assemblyproximally along body 210, biasing member 280 biases retracting member270 back to its first position which in-turn fully extends sheath 220from body 210 which then positions the distal end 262 of needle 260within sheath 220.

As with the embodiment as described in FIGS. 1-4, the snare 250 of theembodiment of FIGS. 5-8 is operated independently of the needle 260.FIG. 5 illustrates a configuration for the surgical instrument 200 wherethe snare 250 is fully retracted within sheath 220. In thisconfiguration, sliding finger ring assembly 230 is in a first positionwhere the finger ring assembly 230 is disposed at the proximal end 212Bof body 210. In order to extend a distal portion 252 of snare 250, whichis the working portion of snare 250, from sheath 220, the operator woulddistally move sliding finger ring assembly 230 along body 210, as shownin FIG. 8. Because snare 250 is rigidly attached to sliding finger ringassembly 230, the distal movement of sliding finger ring assembly 230will distally move snare 250 and will thus extend the distal portion 252of snare 250 from sheath 220. Because apertures have been provided insnare attachment member 234, finger ring assembly ring 230 is able toslide along body 210 and not effect motion of needle 260.

Thus, the embodiment for the tool actuator assembly of FIGS. 5-8provides for independent operation of the individual tools of themulti-function surgical instrument and an easily operable mechanism forthe user for actuating each tool.

FIGS. 9-12 illustrate a third embodiment for the tool actuator assemblyof the present invention. As can be seen in FIGS. 9 and 10, surgicalinstrument 300 includes a body portion 310, a housing 320, a firstsurgical tool 350, which is illustrated as a snare, and a secondsurgical instrument 360, which is illustrated as an injection needle.Arranged for sliding motion on body 310 is sliding finger ring assembly330. Housing 320 can be either integrally formed with body portion 310or can be detachably connected to body portion 310 such as by utilizinga threaded male/female connection such as illustrated with connectionjoint 315. Connection joint 315 is illustrated as including a threadedmale portion that is disposed at a distal end 310B of body 310 which isreceived within an internally threaded female portion that is includedin a proximal end of housing 320. However, as mentioned previously, thepresent invention is not limited to any particular configuration forjoining housing portion 320 to body portion 310.

As is illustrated in FIG. 9, housing 320 includes a first channel 322and a second channel 324. Disposed within first channel 322 is pulleycable 323 and disposed within second channel 324 is needle hub 362.Pulley cable 323 includes a gear tooth portion 323B and is rigidlyattached to either sliding finger ring assembly 330 or snare 350 at itsproximal end 323A. Proximal end 323A of pulley cable 323, as describedabove, can be rigidly attached to either sliding finger ring assembly330 or to snare 350 and the present invention is not limited to anyparticular attachment point for proximal end 323A of pulley cable 323.The only requirement is that pulley cable 323 be attached eitherdirectly or indirectly to sliding finger ring assembly 330 such that asthe sliding finger ring assembly 330 is moved distally along bodyportion 310 the pulley cable 323 is also moved distally. As will befurther explained, gear teeth 323B of pulley cable 323 engage with gear370. Pulley cable 323 is a rigid member such that as force is applied topulley cable 323, the pulley cable moves as a rigid body in response tothat application of force.

Disposed within second channel 324 is needle hub 362. Needle hub 362includes gear teeth 364 which also engage with gear 370, as will befurther explained. Injection needle 360 is rigidly attached to needlehub 362. Needle hub 362 is disposed for slidable motion within secondchannel 324. As can be seen, injection port 366 is also provided inneedle hub 362. The purpose of injection port 366 is to be able toprovide fluid that is to be injected into the body of a patient toneedle 360. As can be seen in FIG. 10, a slot 320A is provided inhousing 320 in order to permit needle hub 362 to slidably move withinhousing 320.

Second surgical tool 350, which is a snare device, is disposed withinhousing 320 and extends through body 310 where it is rigidly attached tosliding finger assembly 330. As such, snare 350 passes through slot 362Athat is provided in needle 350 hub 362. Slot 362A in needle hub 362 canbe seen in FIG. 10. The distal portion 350B of snare 350 and 360B ofneedle 360 are disposed within sheath 328 when both tools are in anon-operative position.

The operation of the tool actuator assembly of the present invention asembodied in FIGS. 9-12 will now be described. FIGS. 9 and 10 illustratethe surgical instrument 300 in a configuration where both the snare 350and the injection needle 360 are disposed completely within sheath 328of the surgical instrument 300. FIG. 11 illustrates a configuration forsurgical instrument 300 where needle 360 has been extended from sheath328 of the surgical instrument 300. In order to extend needle 360 fromdistal end 328A of sheath 328, the operator slides finger ring assembly330 proximally along body 310 to the proximal end 310A of body 310 asshown in FIG. 11. By sliding finger ring assembly 330 in a proximaldirection, pulley cable 323 is also moved proximally since pulley cable323 is rigidly connected, either directly or indirectly as describedpreviously, to finger ring assembly 330. The proximal motion of pulleycable 323 causes engagement teeth 323B of pulley cable 323 to engagewith gear 370. The proximal motion of gear teeth 323B causes gear 370 torotate counter-clockwise within housing 320. As gear 370 rotatescounter-clockwise, because gear 370 is also in engagement with gearteeth 364 that are included on needle hub 362, the counter-clockwiserotation of gear 370 will cause needle hub 362 to move in a distaldirection within channel 324. Since needle 360 is rigidly attached tothe distal end of needle hub 362, the distal motion of needle hub 362within channel 324 will extend the distal end 360B of needle 360 fromthe distal end 328A of sheath 328. Thus, through proximal motion offinger ring assembly 330, the inter-action of pulley cable gear teeth323B, gear 370, and gear teeth 364 of needle hub 362 will extend needle360 from sheath 328.

To retract needle 360 back into sheath 328, the sliding finger ringassembly 330 is moved distally along body 310 to its original positionas shown in FIGS. 9 and 10 where snare 350 is still retracted intosheath 328. When sliding finger ring assembly 330 is moved distally tothis position, the pulley teeth 323B will engage with gear 370 to rotategear 370 in a clockwise direction which in-turn will move needle hub 362in a proximal direction which will retract needle 360 back into sheath328.

FIG. 12 illustrates a configuration for surgical instrument 300 wheresnare 350 has been extended outside of sheath 328. In order to extendsnare 350 from sheath 328, an operator will slide finger ring assembly330 in a distal direction along body 310 beyond its position asillustrated in FIGS. 9 and 10. As is illustrated in FIG. 12, finger ringassembly 330 has been moved by an operator to the distal end 310B ofbody 310. The motion of finger ring assembly 330 distally along body 310causes engagement teeth 323B of pulley cable 323 to extend distallybeyond gear 370 and through an aperture that is provided in the distalend of housing 320. Thus, pulley cable 323 is no longer engaged withgear 370 and causes no rotation of gear 370. Since gear 370 is engagedwith needle hub 362 and since gear 370 is not rotated by pulley cable323 when finger ring assembly 330 has been moved distally along body310, the needle hub 362, and consequently, needle 360, are not movedwhen the sliding finger ring 330 is moved distally along body member310. However, since snare 350 is rigidly and directly attached tosliding finger ring assembly 330, the movement of finger ring assembly330 in a distal direction along body 310 will also move snare 350 in adistal direction and will thus expose distal end 350A of the snare 350,which is the working end of the snare, from the distal end 328A ofsheath 328. Thus, through movement of finger ring assembly 330 distallyalong body 310, snare 350 is exposed from sheath 328 of surgicalinstrument 300.

To retract snare 350 back into sheath 328, the operator slides fingerring assembly 330 proximally along body 310 to the position illustratedin FIGS. 9 and 10.

FIGS. 13-16 illustrate a fourth embodiment for the tool actuatorassembly of the present invention. As will be seen, the actuatingassembly of FIGS. 13-16 operates in a similar fashion to the actuatingassembly that was disclosed in FIGS. 9-12, however, the configuration ofthe pulley cable and the engagement gear are modified in the embodimentof FIGS. 13-16. The configuration of the surgical instrument 400 withrespect to the attachment of the snare and the needle assembly withinthe surgical tool are similar for the fourth embodiment of FIGS. 13-16.

As can be seen in FIG. 13, surgical instrument 400 again comprises abody portion 410 and a housing 420. Housing 420 is attached to bodyportion 410 through connection joint 415, which is similar to that aswas described in the embodiment of FIGS. 9-12. Slidably mounted on bodyportion 410 is finger ring assembly 430. Housing 420 includes a firstchannel 422 and a second channel 424. Disposed within first channel 422is pulley cable 423. Pulley cable 423 is rigidly attached, eitherdirectly or indirectly, to finger ring assembly 430 such that it movesin conjunction with finger ring assembly 430. Pulley cable 423 alsoincludes a stop member 423B which is disposed at a distal end of pulleycable 423.

Disposed within second channel 424 is needle hub 462. Needle hub 462includes engagement teeth 464 and injection port 466. Rigidly attachedto needle hub 462 is injection needle 460. Injection needle 460 isrigidly attached to needle hub 462 at its proximal end 460A and thedistal end 460B of needle 460 is disposed within sheath 428, which isincluded at the distal end of housing 420 when it is in a non-operativeposition. Snare 450 extends proximally through housing 420 and isrigidly attached at its proximal end 450A to sliding finger ringassembly 430. Snare 450 passes through housing 420 in channel 424 andthus needle hub 462 includes a slot 462A to permit snare 450 to passthrough channel 424 without interfering with the movement of needle hub462. Distal end 450B of snare 450 extends from distal end 428A of sheath428 when it is in an operative position.

Also included in housing 420 is gear 470. In the embodiment of FIGS.13-16, gear 470 is not configured as a circular gear as was the gear inthe embodiment of FIGS. 9-12. However, the function of gear 470 issimilar to the function that was performed by the gear of FIGS. 9-12.Gear 470 is mounted on pin 421A that is disposed within housing 420. Assuch, gear 470 is able to rotate about pin 421A. Gear 470 includesengagement teeth 472 which cooperate with engagement teeth 464 that areincluded on needle hub 462. Gear 470 also includes a channel 473 throughwhich passes pulley cable 423. Stop member 423B of pulley cable 423 isdisposed on the distal side of the channel 473 that is within gear 470.As such, pulley cable 423 is not able to be retracted fully throughchannel 473. Pulley cable 423 will be prevented from being retractedcompletely through gear 470 by the interaction of stop member 423B withthe structure of gear 470 that defines channel 473.

Also included on gear 470 is pin 474. As will be explained, pin 474cooperates with biasing member 480. As will be further explained,biasing member 480 cooperates with pin 474 and pin 421B, which isdisposed within housing 420, to bias gear 470 into a first positionwhere needle 460 is retracted within sheath 428.

The operation of the tool actuator assembly for the embodiment of FIGS.13-16 will now be described. FIGS. 13 and 14 show a configuration forsurgical instrument 400 where both the needle 460 and the snare 450 arefully retracted within sheath 428. FIG. 15 illustrates a configurationfor the surgical tool 400 where injection needle 460 has been extendedfrom sheath 428.

In order to extend needle 460 out through sheath 428, the operatorslides finger ring assembly 430 proximally along body 410 to a positionas shown in FIG. 15. Again, because pulley cable 423 is rigidly attachedto finger ring assembly 430, either directly or indirectly, the proximalmovement of finger ring assembly 430 along body 410 will also proximallymove pulley cable 423. When pulley cable 423 is moved proximally, stopmember 423B will engage with gear 470 and will pivot gear 470 in acounter-clockwise direction about pivot pin 421A. Because stop member423B is sized such that it can not pass completely through channel 473that is formed within gear 470, the proximal motion of pulley cable 423will rotate gear 470 counter-clockwise because of the interaction ofstop member 423B and the structure defining the channel 473. The slidingfinger ring assembly 430 must be moved proximally along body 410 withsufficient force such that gear 470 can be rotated counter-clockwiseagainst the biasing force that is applied to gear 470 by biasing member480. As gear 470 is rotated counter-clockwise about pivot pin 421A,engaging teeth 472 of gear 470 will engage with teeth 464 of needle hub462. As gear 470 continues to rotate in a counter-clockwise directionthe interaction of gear teeth 472 with gear teeth 464 will move needlehub 462 in a distal direction within channel 424 of housing 420. Becauseneedle 460 is rigidly attached to needle hub 462, the distal motion ofneedle hub 462 will also distally move the distal end 460B of needle 460within sheath 428 and thus extend distal end 460B of needle 460 beyonddistal end 428A of sheath 428.

When the operator discontinues applying force to finger ring assembly430, the biasing member 480 will act to rotate gear 470 in a clockwisedirection which in-turn will move hub 462 proximally within channel 424in housing 420. Thus, when the operator releases the force on fingerring assembly 430, the injection needle is automatically retractedwithin sheath 428 due to the biasing member 480 acting upon gear 470 torotate the gear back in a clockwise direction. The clockwise rotation ofgear 470 proximally moves needle hub 462 within channel 424 thusretracting needle 460 within sheath 428.

FIG. 16 illustrates a configuration for surgical instrument 400 wheresnare 450 has been exposed from sheath 428. In order to extend snare 450from sheath 428, the operator will slidably move finger ring assembly430 along body 410 in a distal direction. FIG. 16 illustrates slidingfinger ring assembly 430 after it has been moved to the distal end 410Bof body 410. When finger ring assembly 430 is moved distally along body410, pulley cable 423 passes through channel 473 that is provided ingear 470. Stop member 423B passes through a distal portion of channel422 in housing 420 and the distal-most portion of pulley cable 423extends out through an aperture in housing 420 that is located in thedistal portion of housing 420. Thus, there is no interaction betweenpulley cable 423 and gear 470. Pulley cable 423 merely passes throughgear 470. Therefore, distal motion of finger ring assembly 430 does notresult in any rotation of gear 470. However, because snare 450 isrigidly attached to sliding finger ring assembly 430, as sliding fingerring assembly 430 is moved distally, the snare is also moved distallysuch that it is extended from the distal end 428A of sheath 428. Becauseslot 462A has been provided in needle hub 462, snare 450 is able to passby and through needle hub 462 without causing any movement of needle hub462 within channel 424. As such, FIG. 16 illustrates a configurationwhere a distal end 450B of snare 450, which is the working end of snare450, has been extended from sheath 428.

To retract snare 450 back into sheath 428, the operator slides fingerring assembly 430 proximally along body 410 to the position illustratedin FIGS. 13 and 14.

FIG. 17 illustrates a fifth embodiment for a tool actuator assembly inaccordance with the principles of the present invention. As can be seen,surgical instrument 500 includes a body portion 510 and a housing 520.Body portion 510 is a hollow cylindrical member that includes a firstsurgical tool 550 within it. For purposes of illustration, firstsurgical tool 550 will be discussed as a snare, however, first surgicaltool 550 may be any of a variety of different surgical tools. Slidablydisposed on body 510 is finger ring assembly 530. Finger ring assembly530 is disposed on body 510 such that it is able to move proximally anddistally along body 510. Snare 550 is rigidly attached to finger ringassembly 530 at a proximal end 550B of snare 550. Thus, as slidingfinger ring assembly 530 is moved along body 510, snare 550 is alsomoved within body 510. Attached to snare 550 is coupler 552. Coupler 552is rigidly attached to snare 550 and is disposed within body 510. Adistal end 510A of body 510 includes a male threaded portion such thatit is able to be joined to housing 520 which includes an internallythreaded female portion. Body 510 is joined to housing 520 at connectionjoint 515.

Housing 520 includes a second surgical tool assembly, which for purposesof illustration will be discussed as injection needle 560. As can beseen in FIG. 17, housing 520 includes needle hub assembly 564 and needle560, which is connected to needle hub assembly 564. Injection port 562is provided on needle hub assembly 564 in order to provide a fluid toinjection needle 560 for injection into the body of a patient, inaccordance with well-known principles. Needle hub 564 is disposed withinchannel 522 which is formed within housing 520. Thus, needle hub 564 isable to move both distally and proximally within housing 520. Slot 524is provided in housing 520 to permit injection port 562 to extend upthrough housing 520 and permit injection port 562 to be able to be movedalong with needle hub 564 within housing 520.

Also provided within housing 520 is biasing member 525. Biasing member525 is disposed in a distal end of channel 522 and biases needle hub 564in a proximal direction within housing 520. With needle hub 564 biasedproximally within housing 520, distal end 560A of needle 560 does notextend beyond a distal portion of a sheath (not shown in FIG. 17) whichis attached to the distal-most end 520A of housing 520 and whichcontains the distal portions of both needle 560 and snare 550 within itwhen both tools are in a retracted position.

Thus, as can be seen in FIG. 17, housing 520, which includes a needleassembly, provides the capability to reconfigure a known snare toolassembly such that it is able to have the additional functionality of aninjection capability without requiring modification of the snareassembly itself. Housing 520 is merely attached to the snare instrumentwithout requiring modification of the snare instrument. The operation ofthe multi-function surgical instrument 500 will be explained below.

In order to extend snare 550 from a sheath that is attached to housing520 and which encloses snare 550, the operator would slide finger ringassembly 530 in a distal direction along body 510. Distal movement offinger ring assembly 530 will move distal end 550A distally within thesheath such that the distal end 550A of snare 550 will extend from thedistal end of the sheath. Thus, distal motion of finger ring assembly530 extends snare 550 from the sheath of the surgical instrument 500. Aslot 566 is provided in needle hub 564 in order to permit snare 550 tomove within housing 520 without being impeded by needle hub 564. As willbe explained, the distal movement of snare 550 will also extend needle560 from the sheath. Thus, both snare 550 and needle 560 are extendedfrom the sheath of surgical instrument 500 by the movement of fingerring assembly 530 distally along body 510.

As snare 550 is moved distally within body 510, coupler 552, which isrigidly attached to snare 550 within body 510, also is moved distallywithin body 510. As snare 550 continues to move distally within body510, coupler 552 will exit through an aperture included in the distalend 510A of body 510. As coupler 552 exits the distal end 510A of body510, it will enter the proximal end of housing 520. As coupler 552enters the proximal end of housing 520, it will engage with the proximalstructure 568 of needle hub 564. Because coupler 552 is formed such thatit is larger in size than channel 566 that has been formed in needle hub564, it will not merely pass by hub 564 through channel 566, but ratherwill than engage the structure 568 at the proximal end of needle hub564. The engagement between coupler 552 and needle hub 564 will moveneedle hub 564 distally within housing 520 as coupler 552 continues itsdistal movement along with snare 550. Sufficient force must be appliedto snare 550, and thus coupler 552, such that it can move needle hub 564distally within housing 520 against the biasing force that is applied bybiasing member 525. As needle hub 564 moves distally within housing 520,needle 560, which is attached to needle hub 564, also moves distallywith respect to housing 520. This distal movement of needle 560 willcause the distal end 560A of needle 560 to extend from a distal end ofthe sheath that encloses the needle. Thus in this manner, the distalmotion of snare 550 also causes distal motion of needle 560, resultingin extension of both snare 550 and needle 560 from surgical instrument500.

In order to retract snare 550 and needle 560 back into the sheath of thesurgical instrument 500, a user would move finger ring assembly 530 in aproximal direction along body 510. Proximal motion of finger ringassembly 530 along body 510 will also move snare 550 in a proximaldirection with respect to body 510. Continued proximal motion of snare550 will result in distal end 550A of snare 550 being retracted withinthe sheath of the surgical instrument 500. As snare 550 is movedproximally within surgical instrument 500, forward pressure will nolonger be applied to needle hub 564 by coupler 552. As the forwardpressure is removed from needle hub 564, biasing member 525 will forceneedle hub 564 to move proximally within channel 522 in housing 520. Theproximal movement of needle hub 564 within channel 522 under the biasingforce of biasing member 525 will retract the distal end 560A of needle560 within the sheath of the surgical instrument 500.

FIGS. 18-24 illustrate a sixth embodiment for a tool actuator assemblyin accordance with the present invention. As can be seen in FIG. 18,surgical instrument 600 includes a first tool 650 (shown in phantom),which is disclosed as an injection needle, and a second tool 660 (alsoshown in phantom), which is disclosed as a snare. Again, as with theother embodiments that have been previously discussed, the first andsecond tools can be any of a variety of tools and the present inventionas embodied in FIGS. 18-24 is not limited to an embodiment where thesurgical tools are a needle and a snare. As can be seen in FIG. 18,surgical instrument 600 includes a body portion 610, a finger ringassembly 630 slidably mounted on body 610 for movement in both aproximal and distal direction on body 610, a tool actuating member 620,and an injection adaptor port 670. Second tool 660 is attached to fingerring assembly 630 and thus its movement is controlled by finger ringassembly 630. Distal movement of finger ring assembly 630 toward distalend 610A of body 610 will result in the distal end 660A, which wouldinclude a snare loop (not shown), of second tool 660 being extended fromdistal end 610A of body 610. Likewise, proximal motion of finger ringassembly 630 toward proximal end 610B of body 610 will retract distalend 660A of second tool 660 within distal end 610A of body 610.

The actuation of needle 650 is controlled by interaction of finger ringassembly 630 and tool actuating member 620, as will be explainedfurther. Tool actuating member 620 is pivotally attached to body 610 atthe proximal end 610B of body 610. Proximal end 610B of body 610includes a pivot pin 615 that is rigidly attached to body 610. Toolactuating member 620 is pivotally mounted on pivot pin 615. Needle 650is disposed within body 610 of surgical instrument 600 and a proximalportion 650B of needle 650 is rigidly attached to tool actuating member620. Tool actuating member 620 includes a needle attachment portion 622.Needle proximal portion 650B is attached to needle attachment portion622 of tool actuating member 620.

In further describing tool actuating member 620, FIG. 19 illustrates thetool actuating member. As can be seen, tool actuating member 620includes a needle attachment portion 622 and an engagement portion 626.Needle attachment portion 622 is comprised of a first arm member 623 anda second arm member 624. A slot 625 is defined by first arm 623 andsecond arm 624. Included in arm 623 is aperture 623A and included in arm624 is aperture 624A. An attachment pin 629 (visible in FIG. 21 but notshown in FIG. 19) is utilized to attach needle 650 to actuating member620. Needle proximal portion 650B is received within slot 625. Needleproximal portion 650B includes an aperture that also receives attachmentpin 629 within it. The aperture that is defined by needle proximalportion 650B is aligned with aperture 623A and 624A in needle attachmentportion 622. Attachment pin 629 is positioned through aperture 623A, theaperture defined by needle proximal end 650B, and aperture 624A. Thus,needle 650 is attached to needle attachment portion 622.

Engagement portion 626 of tool actuating member 620 defines aperture626A. Aperture 626A receives pivot pin 615, which is attached to body610, within it. Thus, tool actuating member 620 is able to be pivotallymounted to body 610 through pivot pin 615 being received within aperture626A. As can be seen in FIG. 19, the longitudinal axis X₁ of needleattachment portion 622 is off-set from the longitudinal axis X₂ ofengagement portion 626. Additionally, the length L₁ of needle attachmentportion 622 is greater than the length L₂ of engagement portion 626. Thepurposes of the axis off-set and the length difference between needleattachment portion 622 and engagement portion 626 will become clear upondescribing the operation of tool actuating member 620.

The proximal end 610B of body 610 of surgical instrument 600 isillustrated in FIG. 20. As can be seen, the proximal end 610B of body610 includes pivot pin 615. As was mentioned previously, pivot pin 615is received within aperture 626A of tool actuating member 620 topivotally mount actuating member 620 onto body 610. Proximal end 610B ofbody 610 also includes thumb ring 617.

In describing the operation of tool actuating member 620, FIG. 18illustrates tool actuating member 620 in a first position where distalend 650A of needle 650 is retracted within surgical instrument 600. Amore detailed view of the tool actuating member 620 in this firstposition can be seen in FIG. 21. As can be seen in FIG. 21, needleattachment portion 622 is located proximally with respect to body 610.Thus, because needle 650 is attached to actuating member 620 on needleattachment portion 622, needle 650 has been moved proximally withrespect to body 610 of surgical instrument 600. As can be further seenin FIG. 21, finger ring assembly 630 is positioned adjacent toengagement portion 626 of tool actuating member 620, but has not as ofyet exerted any force upon engagement portion 626.

FIG. 22 illustrates actuating member 620 after it has been pivoted toits second position, which in-turn has extended distal end 650A ofneedle 650 from distal end 610A of body 610. A more detailed view forthe positioning of actuating member 620 in its second position whereneedle 650 has been extended from surgical instrument 600 can be seen inFIG. 23. As seen in FIG. 23, finger ring assembly 630 has been movedproximally along body 610 such that the structure of finger ringassembly 630 has engaged with engagement portion 626 of actuating member620. As finger ring assembly 630 continues its movement proximally alongbody 610, the force that is applied to engagement portion 626 ofactuating member 620 causes actuating member 620 to pivotcounter-clockwise about pivot pin 615. This pivotal motion of actuatingmember 620 on pivot pin 615 causes needle attachment portion 622 to movedistally with respect to body 610. Distal motion of needle attachmentportion 622 results in distal motion of needle 650 within body 610. Therotation of actuating member 620 about pivot pin 615 is sufficient todistally move attachment portion 622 such that distal end 650A of needle650 is extended beyond distal portion 610A of body 610. Thus, the distalend 650A of needle 650 is exposed from surgical instrument 600 such thatit may inject fluid into the body of a patient.

As was explained earlier, the longitudinal axis of attachment portion622 is off-set from the longitudinal axis of engagement portion 626.Additionally, the length of needle attachment portion 622 is greaterthan the length of engagement portion 626. These differences between thetwo portions of actuating member 620 results in a mechanical advantagefor moving needle 650 distally within body 610 by pivoting actuatingmember 620. In other words, proximal movement of engagement portion 626of actuating member 620, caused by counter-clockwise rotation of theactuating member 620 through interaction with a proximally movingsliding finger ring assembly 630, will result in a greater length ofdistal movement of needle attachment portion 622 of tool actuatingmember 620. Thus, a relatively small movement of finger ring assembly630 in a proximal direction will result in a significantly greatermovement of needle 650 in a distal direction.

Once the needle has been utilized to injection fluid into a patient,surgical instrument 600 can be removed from the patient and needle 650can be retracted within surgical instrument 600 through manual rotationof actuating member 620 by the user of the instrument. Retraction of theneedle 650 within surgical instrument 600 is not as critical anoperation as extension of the needle because the process of extendingthe needle occurs while the instrument is within a patient and thusefficient movement of the needle while the instrument is in the patientis important. Conversely, after the needle has been utilized to injectfluid into the patient, the surgical instrument can be removed from thepatient and the needle can be manually retracted into the instrument bythe surgeon after the procedure has been performed.

FIG. 24 illustrates an injection adaptor port 670 that can be utilizedwith the embodiment for the surgical instrument as disclosed in FIGS.18-24. Injection adaptor port 670 includes an attachment portion 672that is utilized to attach the injection adaptor port 670 to body 610 ofsurgical instrument 600. Injection adaptor port 670 may include internalthreading at attachment portion 672 that can cooperate with anexternally threaded male portion included at the distal end of body 610in order to attach injection adaptor port 670 to body 610. Distal end674 of injection adaptor port 670 includes an aperture such that distalend 650A of injection needle 650 is able to extend out through theinjector adaptor port 670. Injector adaptor port 670 defines a slot 676that extends from attachment portion 672 to distal end 674. Receivedwithin slot 676 is injection port 655 that is included at the distal end650A of injection needle 650.

FIGS. 25-41 illustrate a seventh embodiment for a tool actuator assemblyin accordance with the present invention. As can be seen in FIGS. 25 and26, surgical instrument 700 is comprised of a body portion 710, asliding finger ring assembly 730, a tool selection and locking switch760, and first and second instrument hubs 740 and 750, respectively. Afirst surgical tool (not shown in FIGS. 25 and 26) would be associatedwith first instrument hub 740 and a second surgical tool (also not shownin FIGS. 25 and 26) would be associated with second instrument hub 750.As will be explained, a surgeon utilizing surgical instrument 700 wouldselect between using the first surgical tool and the second surgicaltool by selectively engaging either the first instrument hub 740 or thesecond instrument hub 750 with tool selection and locking switch 760.The embodiment of FIGS. 25-41 for the surgical instrument 700 is notlimited to any particular tools that may be incorporated into theinstrument. However, for purposes of illustration, it will be describedthat first instrument hub 740 is associated with an injection needle andsecond instrument 750 is associated with a snare device.

In further describing surgical instrument 700, as can be seen in FIGS.25 and 26, surgical instrument 700 is comprised of a body portion 710.Body portion 710 is comprised of a central hub 713, an outer framemember 712, and an outer frame member 714. Central hub 713 and outerframe member 712 define a first channel 712A and central hub 713 andouter frame member 714 define a second channel 714A. Located at a distalend 710A of body portion 710 is sheath attachment portion 716. Sheathattachment portion 716 provides for attachment of a catheter or similarstructure to body portion 710 through which the surgical tools that areassociated with the surgical instrument 700 would extend from bodyportion 710.

Sliding finger ring assembly 730 is slidably mounted onto body portion710. Sliding finger ring assembly 730 is operably associated with toolselection and locking, switch 760 and the first and second instrumenthubs 740, 750, respectively, as will be explained later in thisspecification. First instrument hub 740 is mounted for slidable motionwith respect to body, portion 710 within first channel 712A and secondinstrument hub 750 is likewise mounted for slidable motion with respectto body portion 710 within second channel 714A. Tool selection andlocking switch 760 is comprised of a top switching member 770 and abottom switching member 780 (not visible in FIGS. 25 and 26) andoperably interacts with first instrument hub 740 and second instrument750 to engage one of the instrument hubs with top switching member 770for use of the hub, and consequently the surgical tool associated withthat hub, and lock-out from use the other of the instrument hubs withbottom switching member 780 and the tools associated with thatinstrument hub. The operation of tool selection and locking switch 760and its interaction with the first and second instrument hubs 740, 750will be further explained later in this specification. FIGS. 25 and 26illustrate tool selection and locking switch 760 in a first positionwhere first instrument hub 740 has been engaged by top switching, member770 for use of the surgical tool that is associated with the firstinstrument hub 740 and wherein second instrument hub 750 has beenengaged by bottom switching member 780 in order to lock-out the secondinstrument hub 750 from use by the user of the surgical instrument 700.

FIGS. 27 and 28 illustrate the top switching member 770 of toolselection and locking switch 760 and FIGS. 29 and 30 illustrate thebottom switching member 780 of the tool selection and locking switch760. In first describing top switching member 770, FIG. 27 is a sideview of top switching member 770 and FIG. 28 is a bottom view of the topswitching member 770. As can be seen, top switching member 770 iscomprised of a flat circular planar member 772. Attached to the top ofcircular planar member 772, such that it extends above sliding fingerring assembly 730 when top switching member 770 is mounted withinsliding finger ring assembly 730, is finger grip 774. Attached to abottom portion of planar member 772 are instrument hub actuating member775 and bottom switch member engagement tab 776. Instrument hubactuating member 775 and bottom switch member engagement tab 776 aredisposed on the bottom side of planar member 772 such that they extendwithin sliding finger ring assembly 730 and within body portion 710 toengage with the first and second instrument hubs 740, 750 and bottomswitching member 780, respectively. Instrument hub actuating member 775is an elongated cylindrical member and extends from planar member 772.Bottom switch member engagement tab 776 is also a cylindrical memberthat extends down from planar member 772, however, bottom switch memberengagement tab 776 also includes a v-shaped engagement portion 777,which can be seen in FIG. 28, the purpose of which is to engage withbottom switching member 780. As will be further explained, instrumenthub actuating member 775 engages with instrument hubs 740 and 750 andbottom switch member engagement tab 776 engages with bottom switchingmember 780.

FIGS. 29 and 30 illustrate bottom switching member 780. FIG. 29 is aperspective view of bottom switching member 780 and FIG. 30 is a topview of bottom switching member 780. As can be seen, bottom switchingmember 780 is comprised of a circular base 782, an instrument hublocking member 784, and a top switch member engagement tab 786. Topswitch member engagement tab 786 defines a v-shaped grove 786B which isformed to receive the v-shape engagement portion 777 of top switchingmember 770 within it. Bottom switching member 780 is disposed withinbody portion 710 for rotational motion within body portion 710. As willbe further explained, the purpose of instrument hub locking member 784is to engage with instrument hubs 740 and 750 to lock-out from operationthe engaged instrument hub. The top switch member engagement tab 786 isdesigned to engage with top switching member 770 such that as topswitching member 770 is rotated in order to engage one of the first orsecond instrument hubs 740, 750 with instrument hub actuating member 775to select for use the engaged instrument hub, this rotational movementof top switching member 770 to engage an instrument hub for use alsorotates bottom switching member 780 so that instrument hub lockingmember 784 of bottom switching member 780 engages the other of theinstrument hubs that is not selected for use to lock-out from operationthat instrument hub.

FIG. 31 illustrates the top switching member 770 and bottom switchingmember 780 of the tool selection and locking switch 760 as they would bepositioned with respect to each other within body portion 710 andsliding finger ring assembly 730 (both not shown) within surgicalinstrument 700. As can be seen, bottom switch member engagement tab 776of top switching member 770 has engaged top switch member engagement tab786 of bottom switching member 780 by utilizing the complementaryv-shaped engagement portions of the top switching member 770 and thebottom switching member 780, as described previously. Thus, as can beunderstood, rotational movement of top switching member 770 will alsocause rotational movement of bottom switching member 780 due to theinteraction of the bottom switch member engagement tab 776 and the topswitch member engagement tab 786.

FIGS. 32-34 illustrate the sliding finger ring assembly 730. FIG. 32 isa top view of the sliding finger ring assembly 730, FIG. 33 is a rearview of the finger ring assembly 730, and FIG. 34 is a bottom view ofthe sliding finger ring assembly 730. As can be seen, sliding fingerring assembly 730 is comprised of finger rings 731A and 731B and bodyportion 732. Body portion 732 is a hollow structure that is defined bytop body portion 732A and bottom body portion 732B. As such, bodyportion 710 of surgical instrument 700 is received within surgicalinstrument body aperture 737, which is defined by top body portion 732Aand bottom body portion 732B of finger ring assembly 730, as seen inFIG. 33. Thus, finger ring assembly 730 can be slidably moved along bodyportion 710 of surgical instrument 700.

Top body portion 732A of finger ring assembly 730 defines top switchmember receiving aperture 733, instrument hub actuating member aperture734, instrument hub locking member aperture 735, and instrument hubextension aperture 736. Planar member 772 of top switching member 770 isreceived within top switch member receiving aperture 733 in finger ringassembly 730. As such, top switching member 770 is mounted forrotational motion within sliding finger ring assembly 730. When topswitching member 770 is positioned within sliding finger ring assembly730 for rotational motion within the sliding finger ring assembly, thebottom switch member engagement tab 776 of top switching member 770extends through instrument hub locking member aperture 735 defined bysliding finger ring assembly 730 and instrument hub actuating member 775of top switching member 770 extends through instrument hub actuatingmember aperture 734 which is also defined by sliding finger ringassembly 730. Thus, as mentioned previously, top switching member 770 ismounted for rotational motion within sliding finger ring assembly 730and the rotational movement of top switching member 770 within slidingfinger ring assembly 730 is limited by the motion of instrument hubactuating member 775 within instrument hub actuating member aperture734.

Thus, in referring back to FIG. 31, it can be seen that the unionbetween bottom switch member engagement tab 776 of top switching member770 and top switch member engagement tab 786 of bottom switching member780 extends through the instrument hub locking member aperture 735within sliding finger ring assembly 730. Also, it can be seen thatinstrument hub actuating member 775 of top switching member 770 would bereceived within instrument hub actuating member aperture 734 in slidingfinger ring assembly 730.

Instrument hub extension aperture 736 in sliding finger ring assembly730 extends completely through the top body portion 732A in slidingfinger ring assembly 730 and is provided to accommodate any extensionsfrom instrument hub 740 and instrument hub 750 that may be associatedwith the surgical tools that are carried by the instrument hubs. Forexample, as can be seen in FIGS. 25 and 26, first instrument hub 740includes a fluid port 742 that would be utilized to provide fluidthrough the instrument hub to an injection needle that would beassociated with the instrument hub. Similarly, second instrument hub 750includes an electrocautery insert 752 that would be associated with asnare tool that is carried by the second instrument hub 750. Thus,sliding finger ring assembly 730 is provided with instrument hubextension aperture 736 so that any extensions from the instrument hubsmay be received within the sliding finger ring assembly 730.

FIGS. 35 to 38 illustrate first instrument hub 740. Since secondinstrument hub 750 is formed similar to first instrument hub 740, withthe exception that any extensions from the hubs may be differentlyformed to accommodate the particular surgical tool that is associatedwith the instrument hub, a detailed description will only be provided offirst instrument hub 740. First instrument hub 740 is comprised of a topportion 744 and a bottom portion 746. Attached to top portion 744 isfluid port 742 that would be utilized if first instrument hub 740 wasutilized in combination with an injection needle, as describedpreviously. Top portion 744 defines an instrument hub actuating slot744A. Instrument hub actuating slot 744A is designed to receive in itthe instrument hub actuating member 775 of top switching member 770.When instrument hub actuating member 775 is rotated to be receivedwithin instrument hub actuating slot 774A of first instrument hub 740,first instrument hub 740 is mated with top switching member 770 andthus, movement of sliding finger ring assembly 730 in a distal directionalong body portion 710 of surgical instrument 700 will also move firstinstrument hub 740 distally along body portion 710. Thus, the surgicaltool that is associated with the first instrument hub 740 will also bemoved distally along body portion 710 of surgical instrument 700 suchthat a distal end of the surgical tool would extend from a sheath thatis attached to sheath attachment portion 716 of surgical instrument 700so that the surgical tool could be utilized by the surgeon that isutilizing the instrument 700.

In further describing instrument hub 740, instrument hub 740 includesbottom portion 746. Bottom portion 746 defines an instrument hub lockingslot 746A. Instrument hub locking member 784 of bottom switching member780 is received within instrument hub locking slot 746A of instrumenthub 740. Thus, when instrument hub actuating member 775 of toolswitching member 770 engages with instrument hub actuating slot 744A offirst instrument hub 740, the instrument hub locking member 784 engageswith the instrument hub locking slot of the other instrument hub of thesurgical instrument 700. Thus, through rotation of top switching member770, one of the instrument hubs is engaged by top switching member 770for use and the other of the instrument hubs is locked out fromoperation by bottom switching member 780. The v-grove arrangementbetween top switching member 770 and bottom switching member 780, asdescribed previously, allows for rotation of bottom switching member 780when top switching member 770 is rotated by a user of the surgicalinstrument.

Also associated with first instrument hub 740 is body engagement portion748. Body engagement portion 748 includes retention rails 748A whichextend outwardly from body engagement portion 748 and serve to guide andretain first instrument hub 740 within first channel 712A that isdefined within body portion 710 of surgical instrument 700.

FIGS. 39 and 40 illustrate the tool selection and locking switch 760 asit is used in combination with first instrument hub 740 and secondinstrument hub 750. For purposes of illustration, the tool selection andlocking switch 760 and the first instrument hub 740 and secondinstrument hub 750 are shown without the sliding finger ring assembly730. Top switching member 770 has been rotated so that instrument hubactuating member 775 (not visible in FIG. 39) is received within theinstrument hub actuating slot 744A of first instrument hub 740. Whereasit can not be seen in FIGS. 39 and 40, it can be understood from theprevious discussion that as top switching member 770 is rotated toengage with first instrument hub 740, bottom switching member 780 hasalso been rotated such that it has now engaged with the locking slot ofsecond instrument hub 750 in order to lock-out from operation secondinstrument hub 750.

FIG. 41 is a cross sectional view of surgical instrument 700 taken alonglines 41-41 of FIG. 26. As can be seen, first instrument hub 740 isdisposed within first channel 712A and second instrument hub 750 isdisposed within second channel 714A and top switching member 770 isdisposed within sliding finger ring assembly 730.

In operation, a surgeon that desires to utilize a first surgical toolthat is associated with first instrument hub 740 would rotate topswitching member 770 such that top switching member 770 engages withfirst instrument hub 740. The rotation of top switching member 770 willalso rotate bottom switching member 780 such that it engages with secondinstrument hub 750 in order to lock-out from operation the secondsurgical tool that is associated with second instrument hub 750. Whentop switching member 770 has been rotated to a first position asillustrated in FIG. 25 where the top switching member 770 has engagedwith first instrument hub 740, movement of sliding finger ring assembly730 in a distal direction along body portion 710 of surgical instrument700 will also slide first instrument hub 740 distally along body portion710. Thus, the surgical tool that is associated with first instrumenthub 740 can be extended from surgical instrument 700. Because thesliding finger ring assembly 730, the top switching member 770, andfirst instrument hub 740 are all structurally mated, movement of slidingfinger ring assembly 730 will cause first instrument hub 740 to movealong with sliding finger ring assembly 730. Since bottom switchingmember 780 is rotatably mounted to body portion 710 of surgicalinstrument 700, its engagement with second instrument hub 750 willprevent movement of second instrument hub 750 and thus, lockout fromoperation the surgical tool that is associated with second instrumenthub 750.

If a surgeon desires to utilize the second surgical tool that isassociated with the second instrument hub 750, the surgeon would rotatetop switching member 770 such that it would engage with secondinstrument hub 750. The rotation of top switching member 770 to engagewith second instrument hub 750 would also rotate bottom switching member780 such that it would now engage with first instrument hub 740. Thus,movement of sliding finger ring assembly 730 would now cause movement ofsecond instrument hub 750 along with the sliding finger ring assembly730. Additionally, bottom switching member 780, which is now engagedwith first instrument hub 740, would cause first instrument hub 740 tobe locked out from operation.

Thus, as described, tool selection and locking switch 760 provides forengaging a particular instrument hub for operation of the toolassociated with the instrument hub and locking out a second surgicaltool from operation that is associated with a second instrument hub. Inthis manner, a user of the surgical instrument 700 can select aparticular tool for use and prevent a second tool contained within theinstrument from deployment from the tool.

FIGS. 42-50 illustrate an eighth embodiment for a tool actuator assemblyin accordance with the present invention. As can be seen in FIGS. 42 and45, surgical instrument 800 is comprised of a body portion 810, aslidable finger ring assembly 830, a first instrument hub 840, a secondinstrument hub 850, and first and second actuator buttons 860, 862,respectively. First instrument hub 840 is associated with a firstsurgical tool (not shown) and second instrument hub 850 is associatedwith a second surgical tool (also not shown). The first and second toolscould be any of a variety of tools and the present invention is notlimited to any particular embodiment for the surgical tools that may beutilized in surgical instrument 800. As will be further explained laterin this specification, the first surgical tool would be extended from,and retracted into, surgical instrument 800 by sliding instrument hub840 along surgical instrument 800 and the second surgical tool wouldalso be extended from, and retracted into, surgical instrument 800 bysliding second instrument hub 850 within surgical instrument 800. Aswill also be further explained, first actuator button 860 and secondactuator button 862 are utilized to select which instrument hub isengaged by sliding finger ring assembly 830 so that the surgical toolassociated with the selected instrument hub is able to be extended from,and retracted into, the surgical instrument 800.

In further describing surgical instrument 800, body portion 810 iscomprised of outer frame member 812 and outer frame member 814. Centralhub 813 is disposed between outer frame member 812 and outer framemember 814. As such, central hub 813 and outer frame member 812 define afirst channel outer frame member 812 define a first channel 815 andcentral hub 813 and outer frame member 814 define a second channel 816.Located within outer frame member 812 is a slot 812A that extendsgenerally along the entire length of body portion 810. Similarly, outerframe member 814 also includes slot 814A. As will be further explainedlater in this specification, first actuator button 860 extends throughslot 812A and second actuator button 862 extends through 814A.

Distal end 810A of body portion 810 includes sheath attachment portion816. Sheath attachment portion 816 is provided so that a sheath can beconnected to surgical instrument 800 for insertion into the body of apatient. An aperture (not shown in FIG. 42) extends through distal end810A of body 810 such that the first surgical tool and the secondsurgical tool may extend from surgical instrument 800.

Sliding finger ring assembly 830 is disposed on body portion 810 forslidable motion with respect to body portion 810. Sliding finger ringassembly 830 includes a first finger ring 831A and a second finger ring831B. Body portion 832 of finger ring assembly 830 is a hollow,cylindrical member that receives body portion 810 of surgical instrument800 within it. Disposed on either side of body portion 832 of slidingfinger ring assembly 830 are actuator button housings 834, 835. As canbe seen, first actuator button housing 834 houses first actuator button860 within it and second actuator button housing 835 houses secondactuator button 862 within it. As can be seen in FIGS. 42 and 47, firstactuator button housing 834 includes first actuator button guide pin834A within it and second actuator button housing 835 contains secondactuator button guide pin 835A within it. First actuator button guidepin 834A is disposed within guide slot 860A of first actuator button 860and second actuator button guide pin 835A is disposed within guide slot862A of second actuator button 862. The actuator button guide pins ineach actuator button housing are rigidly attached to the housing. Assuch, the actuator button guide pins, in conjunction with the guideslots in each actuator button, serve to guide and limit the motion ofthe actuator buttons 860 and 862 within actuator button housings 834 and835, respectively.

FIG. 43 illustrates the assembled configuration of first and secondactuator buttons 860, 862 (not shown), respectively, sliding finger ringassembly 830, and first and second instrument hubs 840, 850,respectively. For purposes of illustration, FIG. 43 illustrates theinteraction of the components previously mentioned without illustratingbody portion 810 of surgical instrument 800. In further describing theinteraction of first instrument hub 840, second instrument hub 850,finger ring assembly 830, and first actuator button 860 and secondactuator button 862, first instrument hub 840 and second instrument hub850 will be more fully described.

As can be seen in FIG. 43, first instrument hub 840 is comprised offirst instrument hub extension member 841, first tool attachment member842, and first hub engagement member 844. First tool attachment member842 is a cylindrical body and serves as the attachment mechanism for afirst surgical tool that would be incorporated into surgical instrument800. The surgical tool would attach to the distal end 842A of the firsttool attachment member 842. First instrument hub extension member 841can be integrally formed with first tool attachment member 842. Firstinstrument hub 840 also includes first hub engagement member 844. Firsthub engagement member 844 defines an engagement slot 845 which includesan engagement portion 845A and an open portion 845B. First hubengagement member 844 also includes attachment slot 846 (visible inFIGS. 44 and 47) within it. Attachment slot 846 receives hub attachmentpin 847 (also visible in FIG. 47) within it. Hub attachment pin 847extends up from first tool attachment member 842 and through attachmentslot 846. As such, first hub engagement member 844 is slidably mountedonto first tool attachment member 842 and is movable with respect tofirst tool attachment member 842 in a direction perpendicular to thelongitudinal axis of the first tool attachment member 842, i.e., in adirection transverse to the direction of movement of first instrumenthub 840 within body 810. Extending downward from body portion 832 ofsliding finger ring assembly 830 is first finger ring engagement pin836. First finger ring engagement pin 836 is rigidly attached to slidingfinger ring assembly 830 and is received within engagement slot 845 ofthe first hub engagement member 844.

Similarly, second instrument hub 850 also includes a second toolattachment member 852 which would have attached to its distal end 852A asecond surgical tool. Formed with second tool attachment member 852 issecond instrument hub extension member 851. Also, second hub engagementmember 854, which defines engagement slot 855 and attachment slot 856 isslidably mounted onto second tool attachment member 852. Engagement slot855 also includes an engagement portion 855A and an open portion 855B.Additionally, a hub attachment pin 857 is disposed on second toolattachment member 852 and is received within attachment slot 856. Asecond finger ring engagement pin 837 is rigidly attached to bodyportion 832 of sliding finger ring assembly 830 and extends downwardfrom body portion 832. Second finger ring engagement pin 837 is receivedwithin engagement slot 855 of second hub engagement member 854.

FIG. 44 illustrates the configuration of first and second actuatorbuttons 860, 862, respectively, and first hub engagement member 844 andsecond hub engagement member 854. For purposes of clarity, finger ringassembly 830 is not shown in FIG. 44, however, the first finger ringengagement pin 836 and second finger ring engagement pin 837 and thefirst actuator button guide pin 834A and second actuator button guidepin 835A, which are all rigidly attached to the sliding finger ringassembly 830, are shown so that the structural arrangement between thepins and the associated members can be clearly seen. As can be seen inFIG. 44, body portion 810 of surgical instrument 800 includes anaperture 811 through it so that the hub engagement members 844 and 854may move transversely with respect to body portion 810 and through bodyportion 810, as will be described below.

FIGS. 46-50 illustrate various cross-sectional views of surgicalinstrument 800 as taken along FIG. 45.

In describing the operation of the tool actuator assembly in accordancewith the embodiment of FIGS. 42-50, reference will be made particularlyto FIG. 43. As can be understood in FIG. 43, second actuator button 862(not visible) has been depressed so that it extends entirely withinsecond actuator button housing 835. Motion of second actuator button 862will be restrained against further motion within housing 835 due toengagement of second actuator button guide pin 835A within guide slot862A of second actuator button 862. When second actuator 862 isdepressed into second actuator button housing 835, second actuatorbutton 862 in-turn moves second hub engagement member 854 in a directiontowards the center of surgical instrument 800. As second hub engagementmember 854 is moved in this direction, second finger ring engagement pin837 will be positioned within engagement slot 855 such that secondfinger ring engagement pin 837 is disposed in the open portion 855B ofengagement slot 855.

The movement of second actuator button 862 and second hub engagementmember 854 also forces first hub engagement member 844 and firstactuator button 860 in the same direction. This movement of first hubengagement member 844 causes first finger ring engagement pin 836 to bepositioned within engagement portion 845A of engagement slot 845.Further, in this position, first hub engagement member 844 extendscompletely out of aperture 811 that is included in body portion 810.Thus, first hub engagement member 844 is not constrained against distalmovement along body portion 810 by body portion 810. The movement offirst hub engagement member 844 forces first actuator button 860 toextend out from first actuator button housing 834.

Thus, with second actuator button 862 in this position where it is fullyinserted within second actuator button housing 835, finger ring assembly830, through first finger ring engagement ring pin 836, which is nowengaged with first hub engagement member 844, will allow firstinstrument hub 840 to be moved distally along body portion 810 ofsurgical instrument 800 when sliding finger ring assembly 830 is moveddistally along body portion 810. Because second finger ring engagementpin 837 is now received within open portion 855B of engagement slot 855of second hub engagement member 854, as the finger ring assembly 830 ismoved distally along body portion 810, the second finger ring engagementpin 837 will be moved out of second hub engagement member 854, thus notengaging second hub engagement member 854. The second instrument hubwill then not be selected for movement along with sliding finger ringassembly 830. Because second hub engagement member 854 will be receivedwithin aperture 811 in body portion 810, the second instrument hub 850will, in effect, be locked from distal movement along surgicalinstrument 800.

In order to select the second instrument hub 850 for movement along withsliding finger ring assembly 830, the same procedure as outlined aboveis utilized. As such, to select second instrument hub 850, and thus, asecond surgical tool that is associated with the second instrument hub850, for activation with the sliding finger ring assembly 830, theoperator would depress first actuator button 860 so that it is fullyreceived within first actuator button housing 834. The movement of firstactuator button 860 in this direction would result in the first fingerring engagement pin 836 being received within the open portion 845B ofengagement slot 845 in first hub engagement member 844. Additionally,this movement of first actuator button 860 would force second fingerring engagement pin 837 to be received within the engagement portion855A of engagement slot 855 and second hub engagement member 854. Thus,as sliding finger ring assembly 830 is moved distally along body portion810 of surgical instrument 800, second instrument hub 850 would also bemoved distally along body portion 810 due to the interaction betweensecond finger ring engagement pin 837 and second hub engagement member854.

Thus, the actuator assembly as described in FIGS. 42-50 provide for,selectively engaging a surgical tool for use within surgical instrument800. The surgical tool that is not selected for use is, in effect,locked into position within the body 810 of the surgical instrument 800so that it may not be deployed from the instrument 800.

FIGS. 51-75 illustrate a ninth embodiment for the tool actuator assemblyof the present invention. As will be further described, and as willbecome clear, the surgical instrument 900 of FIGS. 51-75 is similar tothe surgical instruments disclosed in the previous two embodiments inthat it contains two instrument hubs that are engageable by an actuator.However, the configuration of the actuator assembly and hub assembliesare different in the present embodiment from the previous embodimentsdiscussed.

FIGS. 51 and 52 illustrate surgical instrument 900. As can be seen,surgical instrument 900 is comprised of a body portion 910, a guide bar920, a sliding finger ring assembly 930, a first instrument hub 940, asecond instrument hub 950 (not visible in FIG. 51), and a hub actuator960. Each of these components that are associated with surgicalinstrument 900 will be discussed in further detail below. As describedpreviously for embodiments 7 and 8, surgical instrument 900 alsoincludes a first surgical tool and a second surgical tool (not shown inFIGS. 51-75). As such, the first surgical tool would be associated withfirst instrument hub 940 and the second surgical tool would beassociated with second instrument hub 950. The present invention iscapable of being utilized with any of a variety of devices for the firstsurgical tool and the second surgical tool and the present invention isnot limited to any particular embodiments for the surgical tools. Aswill be further explained, the first and second surgical tools arecapable of being extended from, and retracted into, surgical instrument900 by movement of first instrument hub 940 and second instrument 950,respectively, along body portion 910 of surgical instrument 900.

Attached at distal end 910A of body portion 910 is sheath stress reliefmember 980. A sheath can be attached to sheath stress relief member 980for insertion into the body of a patient and the first and secondsurgical tools included in surgical instrument 900 would extend throughthe sheath for insertion into the body of the patient.

FIGS. 53-58 illustrate the guide bar 920 of surgical instrument 900. Ascan be seen, guide bar 920 is comprised of an outer frame member 921, anouter frame member 922, and a central hub 923. Outer frame member 921and central hub 923 define a first channel 920A and outer frame member922 and central hub member 923 define a second channel 920B. As will beexplained further later in this specification, first instrument hub 940is slidably disposed within first channel 920A and second instrument hub950 is slidably disposed within second channel 920B.

Central hub 923 is comprised of a hub guide member 926, which is a flatplanar member. Disposed on the underside and extending perpendicularfrom hub guide member 926 is actuator guide member 924. Actuator guidemember 924 defines an aperture 925 which includes an actuator tab slot925A and an actuator guide structure slot 925B. As will be furtherexplained, actuator tab slot 925A provides an opening within actuatorguide member 924 such that the actuator tab that is associated with hubactuator 960 is able to be rotated through actuator guide member 924from engagement with one instrument hub to engagement with the otherinstrument hub. Actuator guide structure slot 925B provides clearancethrough actuator guide member 924 for the guide structure that isassociated with hub actuator 960. As will also be explained, actuatorguide member 924 guides the movement of hub actuator 960 and the slidingfinger ring assembly 930 along surgical instrument 900.

FIGS. 59-63 illustrate first instrument hub 940 and second instrumenthub 950. Since first instrument hub 940 is formed similar to secondinstrument hub 950, a detailed discussion will only be provided forsecond instrument hub 950, which can be clearly seen in FIGS. 59-63.Second instrument hub 950 is comprised of a body portion 952 and a guideportion 954. Body portion 952 is formed in an elongated rectangularshape. Guide portion 954 extends from the bottom of body portion 952 anddefines a guide slot 954A and an actuator tab engagement slot 954B.Guide slot 954A is formed on both sides of guide portion 954, as can beclearly seen in FIG. 60, and actuator tab engagement slot 954B extendstransversely completely through guide portion 954. Guide slot 954Areceives within it outer frame member 922 of guide bar 920 on one sideof guide portion 954 and receives within it on the other side of guideportion 954 hub guide planar member 926 of central hub 923. Thus, secondinstrument hub 950 is slidably disposed on guide bar 920 within surgicalinstrument 900. Actuator tab engagement slot 954B receives within it hubactuator 960 when the user of surgical instrument 900 desires to selectthe tool associated with second instrument hub 950 for use.

As mentioned above, first instrument hub 940 is formed similar to secondinstrument hub 950 and thus, only a brief description of firstinstrument hub 940 will be provided. First instrument hub 940 is alsocomprised of body portion 942 and guide portion 944. Guide portion 944defines guide slot 944A and actuator tab engagement slot 944B. Guideslot 944A is also formed on both sides of guide portion 944 and thus,guide portion 944 of first instrument hub 940 is received within firstchannel 920A of guide bar 920 such that first instrument hub 940 isslidably disposed on guide bar 920. Actuator tab engagement slot 944Balso receives within it hub actuator 960 when a user of surgicalinstrument 900 desires to select the tool associated with firstinstrument hub 940 for use.

FIGS. 64-66 illustrate the sliding finger ring assembly 930. As can beseen, sliding finger ring assembly 930 is comprised of a body portion931 and first and second finger rings 931A, 931B, respectively, whichare attached at either side of body portion 931. Disposed within bodyportion 931 is guide 934, which defines an aperture 934A within it.Attached to the distal end of guide 934 is actuator guide structurereceiving ring 935. The upper portion of body portion 931 and guide 934define instrument hub receiving aperture 932, the purpose of which is toallow instrument hubs 940 and 950 to be received within finger ringassembly 930, such that hub actuator 960 is able to engage one of theinstrument hubs and thus, the instrument hub is able to be moved alongbody portion 910 along with movement of sliding finger ring assembly 930along body portion 910. Guide 934 and the lower portion of body portion931 define surgical instrument body portion receiving aperture 933 whichreceives the lower body portion of surgical instrument 900 within it.Thus, sliding finger ring assembly 930 is able to be moved along bodyportion 910 of surgical instrument 900. As will become clear later inthis specification, actuator guide structure receiving ring 935 receiveswithin it a portion of hub actuator 960. Thus, hub actuator 960 isstructurally mated to finger ring assembly 930 and is able to rotatewithin the actuator guide structure receiving ring, 935 of finger ringassembly 930.

FIG. 67 illustrates hub actuator 960. As can be seen, hub actuator 960is comprised of a finger grip 961 an actuator tab 962, and guidestructure 964. Guide structure 964 has an outer circular circumferenceand defines a first guide slot 964A and a second guide slot 964B. Aswill become clear, the first and second guide slots alternativelyreceive within them actuator guide member 924 of guide bar 920. As hubactuator 960 is rotated to engage one of the instrument hubs, thelongitudinal axis of one of the guide slots will align with thelongitudinal axis of the actuator guide member 924. Thus, hub actuator960 is able to be moved along guide bar 920 by placing actuator guidemember 924 within one of the guide slots defined by guide structure 964.As hub actuator 960 is rotated, such that the hub actuator engages theother of the instrument hubs, then the other of the guide slots will nowalign longitudinally with actuator guide member 924, such that hubactuator 960 is again able to be moved along guide member 924. Thus, thefirst and second guide slots are used to guide hub actuator 960 alongguide bar 920 when hub actuator 960 engages one of the instrument hubsin surgical instrument 900.

Disposed on guide structure 964 is actuator tab 962. Actuator tab 962extends from guide structure 964 and is located above the horizontalplane of the upper most portion of guide structure 964. Actuator tab 962is received within one of instrument hubs 940, 950 to select aparticular hub for use by the user of surgical instrument 900. Becausehub actuator 960 is rotatably mounted within finger ring assembly 930,actuator tab 962 is able to rotate in order to engage one or the otherof the instrument hubs. As was mentioned previously, actuator guidemember 924 of guide bar 920 includes an actuator tab slot 925A withinit. It is through actuator tab slot 925A that actuator tab 962 is ableto pass through actuator guide member 924 to engage each of theinstrument hubs 940, 950. As was also previously mentioned, actuatorguide member 924 includes actuator guide structure slot 925B. Actuatorguide structure slot 925B receives within it guide structure 964 of hubactuator 960. Thus, guide structure 964 of hub actuator 960 is able torotate without being, impeded by the actuator guide member 924.

FIG. 68 illustrates hub actuator 960 and finger ring assembly 930 in anassembled configuration. For purposes of clarity, the sliding instrumenthubs and the guide bar 920 are not illustrated. As can be seen, theguide structure 964 of hub actuator 960 is received within the actuatorguide structure receiving ring 935 of finger ring assembly 930. As such,hub actuator 960 is structurally mated with sliding finger ring assembly930 and hub actuator 960 is able to rotate within the sliding fingerring assembly 930. FIG. 68 illustrates hub actuator 960 where it hasbeen rotated such that it would engage first actuator hub 940 if firstactuator hub 940 was present in this illustration. It can be seen thatin this position for hub actuator 960, the first guide slot 964A of hubactuator 960 aligns with aperture 934A that is formed within guide 934of sliding finger ring assembly 930. Thus, actuator guide member 924 ofguide bar 920 would be received within aligned aperture 934A and slot964A such that the sliding finger ring assembly 930 and hub actuator 960would be able to be moved along actuator guide member 924 of guide bar920 of surgical instrument 900. As can be understood, if hub actuator960 was rotated such that actuator tab 962 would now engage with secondinstrument hub 950, second guide slot 964B would align with aperture934A in sliding finger ring assembly 930 such that both the hub actuator960 and the sliding finger ring assembly 930 would be able to be movedalong actuator guide member 924 of guide bar 920.

FIG. 69 illustrates the hub actuator 960, the guide bar 920, firstinstrument hub 940 and second instrument hub 950 in an assembledconfiguration to illustrate the interaction between the instrument hubs,the guide bar, and the hub actuator. For purposes of clarity, thesliding finger ring assembly 930 and body 910 are not illustrated inFIG. 69. As can be seen, hub actuator 960 has been rotated such thatactuator tab 962 engages with first instrument hub 940 throughinteraction with actuator tab engagement slot 944B that is formed withinguide portion 944 of first instrument hub 940. As can be further seen inFIG. 69, first instrument hub 940 is slidably mounted on guide bar 920by placing guide bar 920 within guide slot 944A defined by guide portion944 of first instrument hub 940. With hub actuator 960 in this position,it can be seen that first guide slot 964A that is formed within guidestructure 964 of hub actuator 960 is in axial alignment with actuatorguide member 924 of guide bar 920 such that hub actuator 960 is able tobe moved along guide bar 920. Thus, it can be understood that becausethere is a structural connection between hub actuator 960, slidingfinger ring assembly 910 (as illustrated in FIG. 68 and as discussedpreviously), and first instrument hub 940, as sliding finger ringassembly 930 is moved distally along body portion 910 of surgicalinstrument 900, instrument hub 940 will also be moved along with slidingfinger ring assembly 930. Second instrument hub 950 will not move alongbody portion 910 with sliding finger ring assembly 930 because, in thisposition for hub actuator 960, there is no structural connection betweensecond instrument hub 950 and sliding finger ring assembly 930 throughhub actuator 960.

FIGS. 70 and 71 provide cross-sectional views of surgical instrument 900in an assembled configuration. FIG. 70 is a cross-section of surgicalinstrument 900 taken along line 70-70 of FIG. 52 and FIG. 71 is across-section of surgical instrument 900 taken along line 71-71 of FIG.52. Both FIGS. 70 and 71 illustrate hub actuator 960 in a position whereit has engaged first instrument hub 940.

FIGS. 72-75 illustrate the sheath stress relief member 980 of thepresent embodiment. As can be seen, sheath stress relief member 980 iscomprised of a conical portion 982 and a circular portion 984. Circularportion 984 and a portion of conical portion 982 are mounted withindistal end 910A of body portion 910 as can be clearly seen in FIG. 70. Anotch 986 is provided in conical portion 982 that cooperates withstructure on distal end 910A of body 910 to provide stress relief forthe structural connection between stress relief member 980 (and thus asheath (not shown) that is attached to conical portion 982 of stressrelief member 980) and body 910. As can be seen, an aperture extendsthrough sheath stress relief member 980 and is aligned with an aperturethat is included in distal end 910A of body 910 such that the surgicaltools that are associated with surgical instrument 900 may extendthrough body portion 910 and sheath stress relief member 980 and intothe sheath that would be attached to the distal end of the surgicalinstrument.

In operation, a user of surgical instrument 900 would rotate actuatortab 960 to engage one of the instrument hubs 940, 950 to select a toolfor use that is associated with the instrument hubs. By engaging aninstrument hub with hub actuator 960, the selected instrument hub can bemoved along body portion 910 of surgical instrument 900 when the slidingfinger ring assembly 930 is moved along body portion 910. To select theother instrument hub for use, the user of surgical instrument 900rotates hub actuator 960 such that it engages with that instrument hub.Thus, a user of surgical instrument 900 is able to selectively engage asurgical tool for use within surgical instrument 900. Whereas thenon-engaged instrument hub is not locked-out from use, it can not bemoved along body portion 910 of surgical instrument 900 through movementof sliding finger ring assembly 930.

FIGS. 76-79 illustrate a tenth embodiment for a tool actuator assemblyin accordance with the present invention. FIGS. 76 and 77 illustrate thetool actuator assembly 1000. As can be seen in FIG. 76, tool actuatorassembly 1000 is comprised of a body 1010, a first tool receiving member1040, a second tool receiving member 1050, and a tool lock-out switch1030. Tool actuator assembly 1000 also includes catheter 1020, which isattached to distal end 1010A of tool actuator assembly 1000.

Body 1010 is a hollow structure that receives through it a firstsurgical tool, which is illustrated as injection needle 1070 in FIG. 76,and a second surgical tool, which is illustrated as snare instrument1060 in FIG. 76. Injection needle 1070 is received within first toolreceiving member 1040 and extends through body 1010 and catheter 1020where, in an operative position, needle tip 1074 of injection needle1070 extends beyond the distal end 1020A of catheter 1020. Injectionneedle 1070 includes injection port 1072 which is utilized in well-knownmethods. Injection needle 1070 is able to be moved manually in thedirections as illustrated in FIG. 76, such that needle tip 1074 may beextended from catheter 1020 and retracted into catheter 1020.

Second tool receiving member 1050 is internally threaded at its proximalend 1052. As such, snare instrument 1060, which can be a well-knownsnare instrument, can be threaded into second tool receiving member1050. As such, distal end 1060A of snare instrument 1060 is externallythreaded so that it may be received within second tool receiving member1050. Snare rod 1062 of snare instrument 1060 extends from snareinstrument 1060 through second tool receiving member 1050 and body 1010of tool actuator assembly 1000. As such, snare loop 1064, which islocated at distal end 1062A of snare rod 1062, is able to be extendedfrom, and retracted into, catheter 1020.

Snare rod 1062 is attached to sliding finger ring assembly 1066 of snareinstrument 1060 and thus is able to be extended from, and retractedinto, catheter 1020 by moving sliding finger ring assembly 1066 alongthe body of snare instrument 1060 in the directions as illustrated inFIG. 76. As will be explained further below, tool lock-out switch 1030,which is rotatably mounted on body 1010 and which extends into body1010, is utilized to lock-out from operation one of the surgical toolsfrom operation while the other of the surgical tools is being utilizedby the physician.

FIG. 76 illustrates tool actuator assembly 1000 being utilized with aninjection needle 1070 and a snare instrument 1060, however, the presentinvention is not limited to only being utilized with these twoparticular tools. Tool actuator assembly 1000 can be utilized with anyknown surgical tool and can be utilized to lock-out from operation onesurgical tool while the other surgical tool is being utilized by thephysician.

FIG. 78 illustrates the internal working components of tool actuatorassembly 1000. As can be seen, within body 1010 tool lock-out switch1030 is comprised of a hub 1032 which includes a trough 1034 thatextends around a portion of the outer circumference of hub 1032. Trough1034 provides for a reduced diameter for hub 1032 along the portion ofhub 1032 where trough 1034 is located. The purpose of trough 1034 willbe explained below. Also associated with tool lock-out switch 1030 arefirst locking member 1036 and second locking member 1038. Each of thefirst and second locking members 1036, 1038 are illustrated as ballstructures. These locking members are positioned within body 1010 withinchannels that are formed within body 1010. As such, first locking member1036 is contained within first body channel 1037 and second lockingmember 1038 is contained within second body channel 1039. First lockingmember 1036 is disposed between injection needle 1070 and hub 1032 andsecond locking member 1038 is disposed between snare rod 1062 and hub1032. Thus, first locking member 1036 is operably associated withinjection needle 1070 and hub 1032) and second locking member 1038 isoperably associated with snare rod 1062 and hub 1032.

FIG. 79 provides greater detail for the assembled configuration betweenneedle 1070, first locking member 1036, and hub 1032. As can be seen inFIG. 79, needle 1070 is provided with a joint 1078 within it. Needlejoint 1078 provides for a decreased diameter at the center of the jointthan that for the needle along the needle's shaft. Snare rod 1062 isalso provided with a similar joint that may be seen in FIG. 78 as snarejoint 1068.

In operation, tool lock-out switch 1030 locks-out from operation one ofthe surgical tools extending through tool actuator assembly 1000 byengaging a locking member with its associated tool shaft at the joint ofthe tool shaft. The reduced diameter of the joint of the tool shaftallows for the locking member to be positioned within this area ofreduced diameter in the shaft in order to prevent the tool shaft frombeing extended further through tool actuator assembly 1000 and thusextended from the distal end 1020A of catheter 1020. Due to theproviding of trough 1034 within hub 1032, as one of the locking membersis engaged with its associated tool to lock-out the operation of thetool, the other of the locking members will be positioned within therough 1034 of hub 1032 and thus will not be forced by hub 1032 intocontact with the shaft of its associated tool. Thus, the second surgicaltool can be easily moved distally and proximally through body portion1010 of tool actuator assembly 1000 such that the tool can be utilizedby the surgeon in performed a procedure.

FIG. 78 illustrates a position for lock-out switch 1030 where injectionneedle 1070 has been locked-out from operation by first locking member1036. As can be seen, first locking member 1036 has been forced intoengagement with needle joint 1078 through contact between first lockingmember 1036 and the outer circumference 1032A of hub 1032. As can alsobe seen when lock-out switch 1030 is in this position, second lockingmember 1038 is received within trough 1034 of hub 1032. Thus, secondlocking member 1038 is not rigidly engaged with snare rod 1062 and thus,snare rod 1062 is able to be freely moved within body 1010.

As can be understood, in FIG. 78, if hub 1032 was rotated in a clockwisedirection, this clockwise rotation of 1032 would then position firstlocking member 1036 within trough 1034 and second locking member 1038would be caused to be forced out of trough 1034 and would be positionedagainst outer circumference 1032A of hub 1032. After this clockwiserotation of hub 1032, first locking member 1036 would no longer be inrigid contact with injection needle 1070 and thus injection needle 1070would now be able to be freely moved within body 1010 such that it maybe extended from, and retracted into, catheter 1020. It can also beunderstood that now second locking member 1038 will be forced into rigidcontact with snare rod 1062 at its connection joint 1068 and thus thisrigid connection between second locking member 1038 and snare joint 1062will prevent snare rod 1062 from being moved freely within body 1010.Thus, after hub 1032 has been rotated in this clockwise direction, nowinjection needle 1070 may be freely used by the surgeon to perform aprocedure and snare 1060 has now been locked-out from use by thesurgeon. The end regions 1034A and 1034B of trough 1034 can be formedwith camming surfaces such the locking members may easily ride up andout of the trough 1034 as the hub 1032 is rotated from one lock-outposition to another lock-out position.

The disclosed embodiments are illustrative of the various ways in whichthe present invention may be practiced. Other embodiments can beimplemented by those skilled in the art without departing from thespirit and scope of the present invention.

1. A surgical tool actuator assembly comprising: a body, said bodyincluding: a first tool receiving member; and a second tool receivingmember; a first tool disposed within said first tool receiving member; asecond tool disposed within said second tool receiving member; and atool lock-out switch, said tool lock-out switch rotatably mounted insaid body and selectively engageable with said first tool and saidsecond tool; wherein when said tool lock-out switch is rotated to afirst position, the tool lock-out switch engages said first tool withinsaid first tool receiving member; wherein when said tool lock-out switchis rotated to a second position, the tool lock-out switch engages saidsecond tool within said second tool receiving member; and wherein whensaid tool lock-out switch is engaged with one of said first or secondtools, that tool is locked-out from use for a user of the tool.
 2. Thesurgical tool actuator assembly of claim 1 wherein said tool lock-outswitch includes a hub mounted in said body and a first locking memberdisposed between said hub and said first tool receiving member and asecond locking member disposed between said hub and said second toolreceiving member.
 3. The surgical tool actuator assembly of claim 2wherein said hub includes a trough along a portion thereof.
 4. Asurgical tool actuator assembly comprising: a first tool receivingmember; a first surgical tool disposed within said first tool receivingmember; a second tool receiving member; a second surgical tool disposedwithin said second tool receiving member; and a tool lock-out switchcomprising a hub and a first locking member and a second locking member,said tool lock-out switch rotatable relative to said first toolreceiving member and said second tool receiving member, wherein the hubcomprises a trough; wherein when said tool lock-out switch is rotated toa first position, the first locking member is outside of the trough andengages said first surgical tool and prevents advancement of said firstsurgical tool within said first tool receiving member, and the secondlocking member is positioned within the trough; and wherein when saidtool lock-out switch is rotated to a second position, the second lockingmember is outside of the trough and engages said second surgical tooland prevents advancement of said second surgical tool within said secondtool receiving member, and the first locking member is positioned withinthe trough.
 5. The surgical tool actuator assembly of claim 4 whereinwhen said tool lock-out switch is in the first position, the secondsurgical tool is movable within said second tool receiving member; andwherein when said tool lock-out switch is in the second position, thefirst surgical tool is movable within said first tool receiving member.6. The surgical tool actuator assembly of claim 4 wherein the firstsurgical tool has a shaft, the shaft having a joint, wherein when saidtool lock-out switch is in the first position, the first locking memberengages the shaft of the first surgical tool at the joint, therebypreventing advancement of said first surgical tool within said firsttool receiving member.
 7. The surgical tool actuator assembly of claim 6wherein the second surgical tool has a shaft, the shaft having a joint,wherein when said tool lock-out switch is in the second position, thesecond locking member engages the shaft of the second surgical tool atthe joint, thereby preventing advancement of said second surgical toolwithin said second tool receiving member.
 8. The surgical tool actuatorassembly of claim 4 wherein the first and second locking members aremoved by the hub.
 9. The surgical tool actuator assembly of claim 8wherein the trough extends part way around a periphery of the hub. 10.The surgical tool actuator assembly of claim 4 wherein the firstsurgical tool has a shaft, and wherein when said tool lock-out switch isin the first position, the first locking member engages the shaft of thefirst surgical tool, thereby preventing advancement of said firstsurgical tool within said first tool receiving member.
 11. The surgicaltool actuator assembly of claim 10 wherein the second surgical tool hasa shaft, and wherein when said tool lock-out switch is in the secondposition, the second locking member engages the shaft of the secondsurgical tool, thereby preventing advancement of said second surgicaltool within said second tool receiving member.
 12. The surgical toolactuator assembly of claim 9 wherein end regions of the trough havecamming surfaces such the first and second locking members may easilyride up and out of the trough as the hub is rotated between the firstposition and the second position.
 13. The surgical tool actuatorassembly of claim 4 wherein each of the first and second locking membersis a ball structure.
 14. A surgical tool actuator assembly comprising: afirst surgical tool having a shaft, the shaft having a joint; a secondsurgical tool; and a tool lock-out switch, said tool lock-out switchmovable relative to said first tool and said second tool; wherein whensaid tool lock-out switch is moved to a first position, the toollock-out switch engages the shaft of said first surgical tool at thejoint and advancement of the first surgical tool is prevented; whereinwhen said tool lock-out switch is moved to a second position, the toollock-out switch engages said second surgical tool and advancement of thesecond surgical tool is prevented; and wherein when said tool lock-outswitch engages one of said first or second surgical tools, that tool islocked-out from use for a user of the tool.
 15. The surgical toolactuator assembly of claim 14 wherein when said tool lock-out switch isin the first position, the second surgical tool is movable within asecond tool receiving member; and wherein when said tool lock-out switchis in the second position, the first surgical tool is movable within afirst tool receiving member.
 16. The surgical tool actuator assembly ofclaim 14 wherein when said tool lock-out switch is in the firstposition, a first locking member engages the shaft of the first surgicaltool at the joint, thereby preventing advancement of said first surgicaltool.
 17. The surgical tool actuator assembly of claim 16 wherein thesecond surgical tool has a shaft, the shaft having a joint, wherein whensaid tool lock-out switch is in the second position, a second lockingmember engages the shaft of the second surgical tool at the joint,thereby preventing advancement of said second surgical tool.
 18. Thesurgical tool actuator assembly of claim 14 further comprising first andsecond locking members, wherein said tool lock-out switch comprises ahub, and wherein the first and second locking members are moved by thehub.
 19. The surgical tool actuator assembly of claim 18 wherein the hubcomprises a trough extending part way around a periphery of the hub,wherein when said tool lock-out switch is in the first position, thefirst locking member is outside of the trough, and wherein when saidtool lock-out switch is in the second position, the second lockingmember is outside of the trough.
 20. A surgical tool actuator assemblycomprising: a first surgical tool comprising an injection needle; asecond surgical tool; and a tool lock-out switch, said tool lock-outswitch movable relative to said first tool and said second tool; whereinwhen said tool lock-out switch is moved to a first position, the toollock-out switch engages said first surgical tool and advancement of thefirst surgical tool is prevented; wherein when said tool lock-out switchis moved to a second position, the tool lock-out switch engages saidsecond surgical tool and advancement of the second surgical tool isprevented; and wherein when said tool lock-out switch engages one ofsaid first or second surgical tools, that tool is locked-out from usefor a user of the tool.